Argh! Mild arthrosis of the acromioclavicular joint or frozen shoulder

Diabetes Complications and other Conditions
#1

Good grief! Just when I think all I need to is kick up my physical activity my right shoulder starts hurting…a lot!

I started a new job in February and the brass ring was a promotion and raise after 6 months, so I dug in. What I stopped doing was working out regularly because I got an awful cold with a hacking cough, so my visits to the gym stopped. I also started working from home, so my physical activity just plummeted. I got the promotion and raise though, but I’m falling apart physically.

I’m gung-ho to get started with exercise again my right shoulder starts hurting…a lot! At first, I’m thinking it would go away, but it didn’t. It started hurting more. I went to my primary care and they called it: frozen shoulder. He also added that diabetics are prone to this. Of course, I’m thinking again why don’t they warn you about this stuff? I mean I know about limbs getting chopped off, neuropathy, retinopathy, etc. Slightly frustrating, but I know it might not be realistic to give all type 1s a laundry list of the things that can go wrong with them as life goes on.

My primary care referred me to a sports medicine doctor. He listened to my story, put me through some exercises to see what my range of motion was, and gave me the same diagnosis. He also had me go under the x-ray machine. He wrote me later in the day to say it was definitely “mild arthrosis of the acromioclavicular joint”. I start physical therapy 2x a week for 8 weeks, so wish me luck. I hope this brings my range of motion back.

I’m not the only one as I found a thread that was 2 years old about it, but maybe it’s time to start a new one.

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Frozen Shoulder?
#2

Unfortunately we aren’t always told about this sort of thing. I’ve not had a frozen shoulder but I’ve had shoulder and joint problems. My understanding is that high blood sugars can cause thickening of tendons and that can contribute to inflammation which ends up with things like frozen shoulder. I had good luck with physical therapy. You can actually do a lot of the physical therapy at home. In the end, once I got through the most painful part and got back some range of motion (I’ll never have a full range) I was able to start some strengthening exercises (particularly internal and external rotations) which are really good for preventing a recurrence. Some people argue that frozen shoulder goes away on it’s own, but I don’t know. I’d rather work to get rid of it cause it really impairs your life (I had trouble sleeping).

All this conversation also reminds me I’ve totally slacked on my exercises.

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#3

My frozen went away after 1 and 1/2 years. I did my own physical therapy though. It’s just common sense to keep it moving, and most doc gives a steroid shot and I didn’t want one. It’s good now, but it was painful and I didn’t get much sleep. Icy hot or some medicated rub worked pretty well on it for pain.

#4

Yeah, I’d done my research by the time I made it to the sports medicine specialist and had reviewed a few pages on frozen shoulder including this Mayo clinic summary. Both my primary care and sports medicine specialist sent me away with exercises, so I’ll do those too. I just wanted to get sign off from the specialist.

What works for one person may or may not work for another. In the thread I found from a couple of years ago there were replies that PT helped but some folks had to have surgery. I’m hoping I’ve caught it early enough. My specialist did keep the option for pain killers, which I refused, and steroid injections open should things get worse. I’m hoping it doesn’t get that far. It is time for me to really zone in on getting my A1c down to 6.5. I’ve been dealing a lot lately with stubborn highs, but I’m becoming better at bringing them down.

What’s annoying for me is that flexibility is something I always had, so to have this pop up is really frustrating. I’m hoping PT will be able to get me through it and get my range of motion back. My attack plan was getting back to spin class and augmenting with either yoga or Pilates. I’ve gotten sign off for basic exercise including spin classes. Once PT gets going and I know what to expect, I’ll start augmenting it all with visits to the gym again.

Just noticed your comment about exercise! Definitely get back to it!

#5

I’m hoping that happens to me too. I just prefer to have the guidance of a professional for PT because I also want to kickstart my exercise routine. Because of working remote, I was already starting to have issues with a drop in my activity and had started taking regular walks. I want to get more intense because I used to be someone who’d take back to back aerobic classes. I sort of miss that. I won’t ever have the time to be that intense about exercise again, but I need to make it a regular thing. My body is already giving me very strong warnings that if I don’t aging is going to be a tough road for me.

The pain I’m having isn’t so severe that I need a steroid shot, but he did offer pain killers. I refused those because I want to stay aware of what’s going on. The exception I did make was taking ibuprofen at bedtime because Monday night I didn’t sleep well. Of course, the next morning I read that frozen shoulder can also worsen at night. This is definitely a learn as you go condition.

I’ll look into some topical pain remedies too. That’s a great suggestion Roxanne! Thanks.

#6

I had this in one shoulder about 25 years ago and was able to completely fix it with acupuncture from a 7th generation Chinese acupuncturist in southern California. A few years later, I got it in the other shoulder, and went back to her, but was unable to get relief. I had the surgery (can’t remember the word for the small incision type of surgery) - then did months of PT and it’s almost 100% now, but I can’t throw a ball or frisbee with any accuracy whatsoever.

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#7

With diabetes, our entire body is exposed to higher than normal glucose. This extra glucose can stick to any of the tissues of our body, a process known as glycation. I learned about this when I went to physical therapy for plantar faciitis. In my case, the glycated fascia in the bottom of my feet started adhering to adjacent tissue and limiting my range of motion.

Diabetes can cause many secondary complications. I just learned a few years back that hearing loss is another thing added to the long list!

Good luck with the physical therapy. It can work wonders.

#8

Just about 6 months ago I had a shoulder manipulation. I have no problems now. Prior to that though, the orthopaedic specialist tried a cortisone injection. This did nothing but cause havoc on my bg’s for about a week.

The procedure was quite simple. I was put under sedation, doctor broke through all of that scar tissue, I woke up and could raise my arm up over my head.

Sarah :four_leaf_clover:

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#9

There is no known correlation between higher average bg’s and frozen shoulder. In fact most studies I have read, show that A1C’s are slightly lower in those with frozen shoulder, than those without. It seems to depend more on how long one has had diabetes, rather than bg control.

Having gone through frozen shoulder in both shoulders (not at same time) I am very willing to believe that it is an inflammatory anti-immune type thing rather than a result of high bg’s. It is not just arthrosis of the joint, the tissues in the area (including tendon) can become extremely inflamed above and beyond just what’s going on in the joint.

For me at the height of inflammation the pain was so bad, especially trying to sleep, that I would wake up crying. Bad stuff. After the inflammation goes away there’s a different kind of soreness which actually feels good in comparison to the peak of inflammation pain.

Exercises are important in clearing it up but around that you also have to wait for the inflammation to settle down and go away, and that is many months. I had steroid shots into the shoulder joint to help, and I strongly believe they did help, but they also raised my insulin doses for weeks afterwards too. A really good orthopedist will help determine steroid mix and site to help without affecting bg’s too much.

#10

I have had three frozen shoulders. And what I’ve learned is this: if you have physical therapy and do painful exercises, they get better slowly over a period of months. If you do nothing at all, they get better slowly over the same period of months.

Accupuncture can help dramatically, but only after a couple months have gone by and the original inflammation is gone, so you are dealing with muscles that have got stuck in some kind of spasm state.

Cortisone is not particularly helpful according to studies, though most orthopedic doctors will urge you to get the shot. I assume this is because it makes the patient feel they’ve done something. Long term cortisone is harmful for these kinds of problems.

All this except for the accupuncture is backed up by solid research. The accupuncture is from my own experience. I had one frozen shoulder that just wouldn’t quit after months. I had two treatments, nothing happened after the first but a couple hours after the second I went from completely unable to move my arm more than a few degrees to having it return to normal. Very impressive! But I have not found accupuncture any use when the inflammation is recent.

#11

I’d had three frozen shoulders, the first almost 15 years ago. I wrote a blog post about the condition two years ago. I think that it has pretty good information and also gives links to a couple of good articles. I am definitely on the same page as Tim12 and Jenny when it comes to my experience and knowledge about frozen shoulder.

I very strongly feel that frozen shoulder has more to it than just blood sugar levels. Somehow there is a “disease process” because the condition has a beginning, middle, and end. I agree with Tim that there is probably an inflammatory/autoimmune component to adhesive capsulitis. If you have arthritis or an injury to your shoulder in addition to frozen shoulder, you may not achieve a full recovery. And unfortunately people with diabetes are less apt to have a full recovery than other folks.

Good luck, Regina, and I hope you start seeing some improvement in your shoulder:-)

#12

Laddie, you wrote in your blog “Frozen shoulder used to be listed on the last page of diabetic complications and was considered to be somewhat unusual.”

Remember, it wasn’t that long ago that a T1 diabetic living 25 years after diagnosis was considered unusual enough that we got real made-out-of-metal medals from Joslin. Today all you get is a paper certificate… you gotta go 50 or 75 years to get a real medal anymore!!!

With frozen shoulder onset coming most often 30 years after diagnosis, few T1’s were getting that far!

I think that as living with T1 for 50 or 75 years becomes more commonplace, the knowledge of related conditions will improve, because it’ll become increasingly rare for us to go blind and have limbs amputated and kidney disease and die so close to diagnosis, and the professionals will do a better job thinking about “related autoimmune inflammatory processes” like frozen shoulder and hypothyroidism, differently than “result of high average bg” complications like retinopathy and kidney disease.

#13

Tim- I am amazed at how many people I know with Type 1 who got their first frozen shoulder at about 25-years duration. That was true for me, a contributor to my blog-Sue from New York, and a younger friend Cynthia.

Very interesting comment that as we get more T1’s living longer and having better BG levels than in the past, we will start seeing a different mix of complications and co-morbities.

#14

I now know a lot more about frozen shoulder. I hope I don’t get any first hand education! Diabetes is really diabolical.

#15

I have had 2 frozen shoulders in the past 3 years. It took over a year and lots of physical therapy for the first one to go away, and then right after - the other shoulder kicked in. Almost 2 1/2 years without full use of my shoulders. this happened at 30 years of Type 1. I am now without any shoulder issues, but my last one is still not 100%.

I read that the shoulder manipulation didn’t work for Type 1 diabetics. That would have saved me a lot of time!

#16

It sure would have been helpful if all of my doctors had known this happens to Type 1 diabetics. I do not know what I would have done if I got it in both shoulders at once. At least I had one good arm each time. I am thrilled that I can hook and unhook a bra, pull a shirt over my head, and sleep without pain!!!

#17

At least mine were spaced farther apart than yours!

I saw a shoulder specialist for my first frozen shoulder. One set of doctors read my MRI and wanted to do surgery for a torn labrum. (My first FS came after a fall and shoulder injury.) The shoulder specialist saw the same MRI and did not agree with the torn labrum. He indicated that even if it were torn, he wouldn’t do surgery until the FS resolved. No way would he do any surgery or manipulation for FS. But some people have good results, so it’s not up to me to give much advice to anyone else except to do your homework and maybe get a second opinion.

#18

I read your blog— I wish I had seen it when you first wrote it. My doctors should know more about this than they do…

#19

Frozen shoulder may be predictive of diabetes years before diagnosis in Type 2.
Carpal tunnel, too.

I have no autoimmunity or inflammation, but all my tendons are a mess thanks to 5+ decades of living with prediabetic sugars. Frozen shoulders, tennis elbows, tarsal tunnel, housemaids knees, you name it, I have had it.

My understanding is that tendons are poorly supplied with blood so they get damaged before other tissues by high blood glucose. Apparently vertebral discs also respond badly to modestly high sugars. I have almost none left by now after many ruptures. This tendon/disc stuff is my only real complication, and not reversible, alas.

#20

Jenny, I do have a history of tendon issues. Hard to tell what is diabetes-related and what is just a baby-boomer pushing her body too far. I also wonder if like everything else, the triggers for frozen shoulder differ from person to person. It just has to be more than blood sugars. If it were just blood sugars, why would a frozen shoulder ever go away? My most recent one happened after six months with an A1c of 5.0 followed by one at 5.2. It is completely resolved now and my A1c is now 5.7. I would never argue that I have normal blood sugars. But my blood sugars are the same when I have frozen shoulder and when I don’t.